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--------.,
H 3000.3 015a 2003 c.l
The First Annual Report
of the
Olmstead Strategic Planning Committee
July 15, 2003
"Making Olmstead a Reality in Oklahoma"
Prepared by Olmstead Strategic Planning Committee Co-Facilitators:
Gina McDonald Kansas Association of Centers for Independent Living
Rose Ann Percival Department of HumanServices Developmental
Disabilities Services Division
Appointed Members
Governor's Appointees
Dana Partridge
Doug Bursey
Eddie Miller
Norma Ferguson
Oklahoma City Housing Authority
Mark Gillett
Housing Finance Agency
Nancy English
Senate Appointees
Senator Bernest Cain, Co-Chair
Senator Ben Robison
Laura Dempsey Polan
Department of Education
Kathy Riddle
Pat Sholar
House Appointees
Representative Bill Nations, Co-Chair
Representative Bill J. Mitchell
Jan Moss .
Department of Transportation
Kenneth LaRue
Department of Labor
Michael Taylor
Attorney General's Office
Mark Jones
Commission on Children & Youth
Caroline Clark
Department of Human Services
Howard Hendrick
James Nicholson
Department of Health
Michael Harmon
Developmental Disabilities Council
Ann Trudgeon
Statewide Independent Living Council
Charlotte Bowen
Department of Mental Health
Kathy Otis
Centers for Independent Living
Jeff Hughes
Oklahoma Health Care Authority
Michael Fogarty
Trevlyn Terry
Ability Resources
Carla Lawson
Oklahomans for Independent Living
Mike Ward
Office of State Finance
Jenonne Kessler
Department of Rehabilitation Services
Linda Parker
Dan O'Brien
Center for Learning & Leadership
Vyonda Martin
Oklahoma Disability Law Center
Kayla Bower
Office of Handicapped Concerns
Steve Stokes
ABLE-Tech
Linda Jaco
Employment Security Commission
Bob Vanek
Oklahoma Mental Health
Council Kay Rote
Green Country Independent Living
Judy Viles
Wichita Independent Living Center
Charles Webber
2
ADDENDUM
To the
First Annual Report of the Olmstead Committee
July 15, 2003
The Olmstead Strategic Planning Committee met on July 10, 2003, to review and
approve this report. Some issues were raised at the meeting and several members
asked that an addendum be attached to the report.
Replace the purpose of the Diversion Subcommittee with the following: (pg. 21)
To develop a plan for ensuring all Oklahomans with disabilities have
access to informed choice in services in the most integrated settings
and those services are a reality.
The Diversion Subcommittee submitted a model, "Life Empowerment Model",
for this working document. This model was not included in this report
because the full Olmstead Strategic Planning Committee had not had a
chance to review the model. The model and related recommendations will be
reviewed in Committee for approval.
The Dollar Follows Subcommittee has a more extensive report. Contact Dana
Partridge or Jeff Hughes, Subcommittee Co-Chairs, for a copy.
The tables in the back of the report do not represent the actual numbers of people
being served, but close approximations. As soon as any numbers are published,
they change.
In the Education Section of the Community Supports Subcommittee, information
and goals will be added for infant and toddler transitions (SoonerStart).
This report does not include all the activity of the Committee or Subcommittees.
Certain progress is being made in Oklahoma that will be tracked during the next
year. For example,
1. OKAPSE is pursuing a grant to address integration and inclusion in work
force centers.
2. ABLE Tech is pursuing a grant on helping with home repair and
accommodations.
This report will be disseminated broadly. Contact Rose Ann Percival at (405) 522-
0600 or e-mail RoseAnn.Percival@okdhs.org.
INTRODUCTION
The Oklahoma Olmstead Strategic Planning Committee was developed as
a result of the commitment and hard work of many advocates, state
agencies, consumers, families and most especially the commitment of the
Oklahoma State Legislature and Governor. In particular, we wish to
acknowledge the critical role of Senator Bernest Cain and Representative
Bill Nations, who regularly attend our Task Force Meetings.
It has from the beginning, been the priority of the Planning Committee to
look across service categories and begin to develop priorities that would
make the Olmstead decision a reality in Oklahoma .
.~~
The Olmstead Strategic Planning Committee, which was appointed by the
Governor, President Pro Tempore of the Senate and Speaker of the
House, has been meeting for nine months to determine how to best meet
their mission.
The Committee and subcommittees have accepted the task of examining
all of the service delivery systems across the State of Oklahoma and
developing recommendations to make these systems easily accessible,
consumer and family friendly, and cost efficient.
The Committee and its subcommittees have reached several conclusions
in the first nine months of this task. Oklahoma does not have a statewide
system of family support. Family Support is typically defined as "whatever it
takes" for families and people with disabilities to live as much as possible
like other families. This incorporates the use of supports, resources,
services, financial assistance and other forms of assistance to meet the
needs of people with disabilities and their families to enable them to live in
their community of choice. Oklahoma needs to recognize the importance of
the person with a disability and the family in developing, delivering and
evaluating policies and practices.
Oklahoma needs funding and services that are flexible. Families are tired of
being put in a box and forced to accept whatever services are available,
whether these services adequately meet their needs or not. More and more
systems are moving toward self-directed programs. Putting the money and
resources in the control of consumers and families is a way to assure that
needs are met and the money is spent only on what is needed.
3
A. BACKGROUND:
The Americans with Disabilities Act (ADA) was signed into law on July 26,
1990. The ADA was designed to give people with disabilities increased
opportunities. by making it illegal to discriminate in many areas such as
employment, public accommodations, and transportation. The ADA was
considered to be the beginning of equality in America for persons with
disabilities.
Recently, a Supreme Court case filed under the ADA dealt specifically with
issues related to community placement. Olmstead v. L'C. involved two
Georgia women residing in a State mental health facility. Both plaintiffs had
dual diagnoses of mental illness and mental retardation. Though both
parties were eligible for community-based services through an existing
State program which had open slots to serve them, the women were
denied community placement because of inadequate. In June 1999, the
Supreme Court determined that "unjustified isolation is discrimination under
the ADA and required that the women be served "in the most integrated
setting appropriate to (their) needs
The Olmstead decision established specific criteria to assist the State in
determining when community based services are required for persons with
disabilities:
• When the State's treatment professionals determine that community
placement is appropriate.
• When the transfer from institutional care to a less restrictive setting is
not opposed by the affected individual with informed choice.
• When placement can be reasonably accommodated, taking into
account the resources available to the state and the needs of others.
To provide additional clarification, the Supreme Court further indicated that
a State could demonstrate that it had met the "reasonable accommodation"
standard by demonstrating that is has:
• a comprehensive, effectively working plan for placing qualified
persons with disabilities in the most integrated setting appropriate,
and
5
C. VALUES THAT WERE USED IN THE DEVELOPMENT OF THE PLAN.
The Olmstead committee agreed to adopt the following values that were
developed by The Oklahoma Family Support Partnership.
OKLAHOMA INDIVIDUAL AND FAMILY SUPPORT PRINCIPLES ...are
guiding truths that shape the way individuals, families and service providers
interact ...establish common ground upon which individuals, families,
advocates and service providers operate ...form the basis for program
policy and practice.
WHEN WE ENGAGE WITH INDIVIDUALS AND FAMILIES WE WILL ...
HONOR THEIR EXPERTISE and right to make choices that they know to
be in their own best interest.
RESPECT AND ACCEPT THEIR VALUES that are based in personal
preferences, cultural beliefs and life-ways.
SUPPORT INDIVIDUAL AND FAMILY RELATIONSHIPS that are safe,
stable and long lasting.
FOCUS ON THE ENTIRE FAMILY as it is defined by the family.
PROMOTE FLEXIBLE SERVICE AND FUNDING supporting individual
and family control over who, what, when, where and how supports are
provided.
AFFIRM LIFESPAN PLANNING AND SELF-DETERMINATION that
encourages decision-making and planning for independence beginning
within the family when children are young, following the individual
throughout their life and including aging issues.
ASSURE PARTNERSHIPS WHICH ACTIVELY INCLUDE INDIVIDUALS
AND FAMILIES in planning, development, implementation and evaluation
of policies, practices and personal programs.
PRACTICE OPEN COMMUNICATION promoting a clear understanding of
all aspects of systems policy, procedure, practice and all other information
regarding them.
7
Principle Three:
Integration.
Community living includes physical, social, political, educational, and
economic integration.
GUIDELINES
The integration mandate applies to all areas of community living including
personal assistance, access to the faith community, education,
employment, health care, housing, assistive technology, recreation, and
transportation.
Services and resources are equally accessible to diverse populations.
Permanent infrastructure supports individual choices.
Funding follows the individual.
Personal relationships and community membership are valued and
supported.
Lifespan planning and self-determination encourages decision-making and
planning for independence beginning with the family and the children when
the children are young.
Segregation based on disability is unlawful discrimination.
There will be five subcommittees to accomplish the work of the large
committee. They are:
1. Dollar Follows the Individual.
2. Quality Assurance.
3. Diversion
4. Community Supports and Services.
5. Finance.
9
Goal: Explore changing the State 209(b) status and use SSI
eligibility as the financial standard. Additional funds may be needed to
expand the Medicaid population.
Agents of Change: Oklahoma Health Care Authority (OHCA),
Department of Human Services (DHS), State Legislature, Consumers,
Advocates
2. QMB-Qualified Medicare Beneficiary
Dually Eligible - Medicare/Medicaid individuals. Low income threshold is a
disincentive to enter the work force.
Goal: Study the need for a policy change that would allow for an
increase to earned income levels for dually eligible individuals.
Agents of Change:
Advocates
DHS, OHCA, State Legislature, Consumers,
3. Supplemental Security Income Work Incentive-1619(b)
SSI individuals can have an earned income that allows continued
Medicaid eligibility based on Social Security regulation 1619 (a) and (b).
Current policy language creates confusion between responsible agencies
because the OK Medicaid agency policy does not meet federal regulation
that would allow an individual to have a 1619 (b) status.
Goal: Policy change would be needed OAC 317:35-7-38(3)(E)
to eliminate the link between receiving 1619 (b) status and the state
supplement payment, based on earned income, for continued Medicaid
eligibility.
Agents of Change:
Advocates
OHCA, DHS, Social Security, Consumers,
11
3. Pre Employment Consideration
Making informed choices regarding employment, i.e. job match, benefits,
safety, and health. Poor planning that results in unsuccessful employment
outcome.
Goal: Enhance training and coordination of employment and/or
transitional services that will result in positive outcomes.
Agents of Change: DRS, SDE, DHS, Workforce, Oklahoma
Employment Security Commission (OESC), DMHSAS, OBPAP, Centers for
Independent Living (Cll), Oklahoma Association for Supported
Employment (OK-APSE)/ Consumers, Advocates
C. Assistive Technology
Medicaid Recipients Need Access to All Types of DME.
Restrictions exist on various types of DME such as, bath and toilet aids,
prosthetics, orthotics and alternative, augmentative communication (AAC).
lack of access to appropriate medically necessary equipment creates a
barrier to community living.
Goal: Amend policy to eliminate 'exclusive lists' and state plan
options for DME.
Agents of Change: OHCA, Oklahoma State Department of Health
(OSDH), ABLE Tech, DHS, Consumers, Advocates
D. Direct Support Services
1. Personal Care Services
PCS in state Medicaid plan can be provided in the home, educational or
work setting. lack of information regarding current policy on PCS creates
low utilization.
13
The appropriate Oklahoma State Legislative Committee explore and
develop employee recruitment and retention incentives for all providers of
long-term care services.
Goals:
1. State agencies will address payment issues.
2. Service provider agencies will enhance hiring practices and reduce
turnover by addressing factors, such as, supervisory training, recruitment,
training and professional development, mentoring and counseling and
wages and benefits.
Agents of Change:
Consumers, Advocates
DHS, OHCA, DRS, Service Providers,
4. Identification of "Faith Based Initiatives" that may serve people
with disabilities.
To identify Faith Based resources in the community that assist people with
disabilities. Faith-Based Initiatives can be a resource for both an individual
with a disability and communities to assist with transition and inclusion.
Goal: Become familiar with the Federal and State's Faith Based
Initiatives to supplement the budgeted outreach of their congregation for
this ministry.
Agents of Change: Oklahoma's Faith Based Liaisons Office,
Developmental Disabilities Council, Consumers, Advocates
E. Transportation
1. Lack of Available Transportation
Persons with disabilities need to participate in the community. Equal
access requires ability to utilize local services and travel to other
communities. Without adequate means of transportation, persons with
disabilities have limited opportunities to participate fully in community living.
15
Agents of Change:
Consumers, Advocates
ODOT, DHS, DRS, State Legislature,
4. Duplication of Transportation Services
Many funding sources restrict a vehicle's usage to only their clients.
Multi vehicles providing transportation services to same site or area.
Goal: Review regulations and, where practical, allow for the
blending of funds.
Agents of Change: Legislative transportation committees,
agencies that spend dollars to provide transportation services, Consumers,
Advocates
F. Education
There are many more aspects of education which need to be reviewed by
the committee. More work needs to be done in this area over the next year
by this or a separate committee
1. Transitioning from High School to Work
High School students may not have access to resources to gain
employment skills, i.e. job coaches. Students may not have employment
outcomes by graduation; yet, transition services end.
When IEP services end, student may lose job because they lose their
transition services.
Goals: Better coordination between various agencies to ensure
continuation. Transition services will begin at age 14 and continue through
age 21, if needed, as mandated by IDEA.
Agents of Change: State Department of Education (SDE), DRS,
Career Technology, Community Supports such as non-profits and
businesses, DMHSAS, One-Stop-Shop Centers, Consumers, Advocates
17
Goal: Urge Oklahoma Public Housing Authorities (PHA)to enact
disability preferences and expedite applications for people transitioning
from institutions.
Agents of Change: HUD, PHA, Consumers, Advocates
3. Home Ownership and Supports
In Oklahoma, many citizens live in institutions who could, with the
appropriate supports, live successfully in the community.
Given their present living arrangements, these individuals have no way to
access mortgages or to take the necessary steps to become home owners.
Goal:
1. Strengthen and expand current HOVO initiatives. (~iJf), yo~•..O~)
2. Encourage state agencies to provide personnel resource assistance to
Community Action Agencies in facilitating the process of home ownership
for specific populations of persons with disabilities (i.e., DHS-DDSD for
persons with developmental delays, DMHSAS for persons with mental
illness.).
3.Establish collaborative community efforts involvinq multiple
agencies/organizations including Community Action Agency to develop
housing for disability populations. It must be acknowledged that individuals
with serious mental illness are not given access to all housing options so
that a priority for homeless mentally ill is recommended. Often the
responsibility for match or the cash outlay falls to one agency. Having the
city, county or state provide the match is an unexplored option. Providing
options for housing, by providing the match, is less costly than supporting
persons in higher levels of care.
Agents of Change: Legislature, Oklahoma Housing Finance
Administration (OHFA), Oklahoma Association of Community Action
Agencies (OACAA), Consumers, Advocates and the Developmental
Disabilities Council
19
c. A method to disseminate information on trends so necessary changes
can be made;
d. A mechanism to identify gaps in services using input from individuals
and families;
e. An education and training component for individuals / families to make
informed decisions; and
f. Individuals and family involvement in the development, implementation
and evaluation of services.
Goals:
1. Develop and recommend guiding principles for QA systems across the
State of Oklahoma.
2. Identify and review relevant QA systems in Oklahoma for best
practices.
3. Review funding mechanisms for QA systems to assure adequate
staffing.
4. Assure consumers, advocates and families are included in the
development of any and all quality assurance programs.
Agents of Change: Consumers, Advocates, Family members,
Department of Human Services, Department of Health, Oklahoma Health
Care Authority
Diversion Subcommittee
Purpose: To market nd facilitate a paradi m shift from ins' utional care as
an entitlement a choice of home and mmunity bas services as the
waive red opti to home and com ity based servi es as the entitlement
and choic f institutional care a the waivered Ion. ~ ~~ ~ ~
Goal 1: Development and continuous refinement of a self-directed
service delivery system.
Objectives:: There is a single point of entry.
a. Identify the basic infrastructure for community based services available
in Oklahoma.
b. Develop the prototype for a Single Statewide Service Delivery Model
with a single point of entry.
21
SUMMARY
This is the first report in a five year ongoing process. There will be a
number of focus groups throughout the State to get feedback from
consumers, family members, providers, advocates and other interested
parties. Their feedback may alter some recommendations and may
advance other options, which will be explored over the next four years.
During the next year, we will add two new committees that will look at
finances, both current and potential, and marketing of concepts and
programs. More committees will be added and removed as the Strategic
Planning Committee determines the needs.
We again want to acknowledge the hard work and commitment of the
Legislature, Olmstead Strategic Planning Committee, other committee
members, advocates, consumers, family members and providers who were
willing to share their stories to put a real face on this important issue.
The Olmstead Strategic Planning Committee would like to thank the
informal Olmstead work groups that worked for almost two years to begin
the process. They developed a foundation upon which this Committee can
build. Their report is attachment #1 in the back of this report.
We know that we must all work together to make this plan a reality and to
"Make Olmstead a reality in Oklahoma".
23

--------.,
H 3000.3 015a 2003 c.l
The First Annual Report
of the
Olmstead Strategic Planning Committee
July 15, 2003
"Making Olmstead a Reality in Oklahoma"
Prepared by Olmstead Strategic Planning Committee Co-Facilitators:
Gina McDonald Kansas Association of Centers for Independent Living
Rose Ann Percival Department of HumanServices Developmental
Disabilities Services Division
Appointed Members
Governor's Appointees
Dana Partridge
Doug Bursey
Eddie Miller
Norma Ferguson
Oklahoma City Housing Authority
Mark Gillett
Housing Finance Agency
Nancy English
Senate Appointees
Senator Bernest Cain, Co-Chair
Senator Ben Robison
Laura Dempsey Polan
Department of Education
Kathy Riddle
Pat Sholar
House Appointees
Representative Bill Nations, Co-Chair
Representative Bill J. Mitchell
Jan Moss .
Department of Transportation
Kenneth LaRue
Department of Labor
Michael Taylor
Attorney General's Office
Mark Jones
Commission on Children & Youth
Caroline Clark
Department of Human Services
Howard Hendrick
James Nicholson
Department of Health
Michael Harmon
Developmental Disabilities Council
Ann Trudgeon
Statewide Independent Living Council
Charlotte Bowen
Department of Mental Health
Kathy Otis
Centers for Independent Living
Jeff Hughes
Oklahoma Health Care Authority
Michael Fogarty
Trevlyn Terry
Ability Resources
Carla Lawson
Oklahomans for Independent Living
Mike Ward
Office of State Finance
Jenonne Kessler
Department of Rehabilitation Services
Linda Parker
Dan O'Brien
Center for Learning & Leadership
Vyonda Martin
Oklahoma Disability Law Center
Kayla Bower
Office of Handicapped Concerns
Steve Stokes
ABLE-Tech
Linda Jaco
Employment Security Commission
Bob Vanek
Oklahoma Mental Health
Council Kay Rote
Green Country Independent Living
Judy Viles
Wichita Independent Living Center
Charles Webber
2
ADDENDUM
To the
First Annual Report of the Olmstead Committee
July 15, 2003
The Olmstead Strategic Planning Committee met on July 10, 2003, to review and
approve this report. Some issues were raised at the meeting and several members
asked that an addendum be attached to the report.
Replace the purpose of the Diversion Subcommittee with the following: (pg. 21)
To develop a plan for ensuring all Oklahomans with disabilities have
access to informed choice in services in the most integrated settings
and those services are a reality.
The Diversion Subcommittee submitted a model, "Life Empowerment Model",
for this working document. This model was not included in this report
because the full Olmstead Strategic Planning Committee had not had a
chance to review the model. The model and related recommendations will be
reviewed in Committee for approval.
The Dollar Follows Subcommittee has a more extensive report. Contact Dana
Partridge or Jeff Hughes, Subcommittee Co-Chairs, for a copy.
The tables in the back of the report do not represent the actual numbers of people
being served, but close approximations. As soon as any numbers are published,
they change.
In the Education Section of the Community Supports Subcommittee, information
and goals will be added for infant and toddler transitions (SoonerStart).
This report does not include all the activity of the Committee or Subcommittees.
Certain progress is being made in Oklahoma that will be tracked during the next
year. For example,
1. OKAPSE is pursuing a grant to address integration and inclusion in work
force centers.
2. ABLE Tech is pursuing a grant on helping with home repair and
accommodations.
This report will be disseminated broadly. Contact Rose Ann Percival at (405) 522-
0600 or e-mail RoseAnn.Percival@okdhs.org.
INTRODUCTION
The Oklahoma Olmstead Strategic Planning Committee was developed as
a result of the commitment and hard work of many advocates, state
agencies, consumers, families and most especially the commitment of the
Oklahoma State Legislature and Governor. In particular, we wish to
acknowledge the critical role of Senator Bernest Cain and Representative
Bill Nations, who regularly attend our Task Force Meetings.
It has from the beginning, been the priority of the Planning Committee to
look across service categories and begin to develop priorities that would
make the Olmstead decision a reality in Oklahoma .
.~~
The Olmstead Strategic Planning Committee, which was appointed by the
Governor, President Pro Tempore of the Senate and Speaker of the
House, has been meeting for nine months to determine how to best meet
their mission.
The Committee and subcommittees have accepted the task of examining
all of the service delivery systems across the State of Oklahoma and
developing recommendations to make these systems easily accessible,
consumer and family friendly, and cost efficient.
The Committee and its subcommittees have reached several conclusions
in the first nine months of this task. Oklahoma does not have a statewide
system of family support. Family Support is typically defined as "whatever it
takes" for families and people with disabilities to live as much as possible
like other families. This incorporates the use of supports, resources,
services, financial assistance and other forms of assistance to meet the
needs of people with disabilities and their families to enable them to live in
their community of choice. Oklahoma needs to recognize the importance of
the person with a disability and the family in developing, delivering and
evaluating policies and practices.
Oklahoma needs funding and services that are flexible. Families are tired of
being put in a box and forced to accept whatever services are available,
whether these services adequately meet their needs or not. More and more
systems are moving toward self-directed programs. Putting the money and
resources in the control of consumers and families is a way to assure that
needs are met and the money is spent only on what is needed.
3
A. BACKGROUND:
The Americans with Disabilities Act (ADA) was signed into law on July 26,
1990. The ADA was designed to give people with disabilities increased
opportunities. by making it illegal to discriminate in many areas such as
employment, public accommodations, and transportation. The ADA was
considered to be the beginning of equality in America for persons with
disabilities.
Recently, a Supreme Court case filed under the ADA dealt specifically with
issues related to community placement. Olmstead v. L'C. involved two
Georgia women residing in a State mental health facility. Both plaintiffs had
dual diagnoses of mental illness and mental retardation. Though both
parties were eligible for community-based services through an existing
State program which had open slots to serve them, the women were
denied community placement because of inadequate. In June 1999, the
Supreme Court determined that "unjustified isolation is discrimination under
the ADA and required that the women be served "in the most integrated
setting appropriate to (their) needs
The Olmstead decision established specific criteria to assist the State in
determining when community based services are required for persons with
disabilities:
• When the State's treatment professionals determine that community
placement is appropriate.
• When the transfer from institutional care to a less restrictive setting is
not opposed by the affected individual with informed choice.
• When placement can be reasonably accommodated, taking into
account the resources available to the state and the needs of others.
To provide additional clarification, the Supreme Court further indicated that
a State could demonstrate that it had met the "reasonable accommodation"
standard by demonstrating that is has:
• a comprehensive, effectively working plan for placing qualified
persons with disabilities in the most integrated setting appropriate,
and
5
C. VALUES THAT WERE USED IN THE DEVELOPMENT OF THE PLAN.
The Olmstead committee agreed to adopt the following values that were
developed by The Oklahoma Family Support Partnership.
OKLAHOMA INDIVIDUAL AND FAMILY SUPPORT PRINCIPLES ...are
guiding truths that shape the way individuals, families and service providers
interact ...establish common ground upon which individuals, families,
advocates and service providers operate ...form the basis for program
policy and practice.
WHEN WE ENGAGE WITH INDIVIDUALS AND FAMILIES WE WILL ...
HONOR THEIR EXPERTISE and right to make choices that they know to
be in their own best interest.
RESPECT AND ACCEPT THEIR VALUES that are based in personal
preferences, cultural beliefs and life-ways.
SUPPORT INDIVIDUAL AND FAMILY RELATIONSHIPS that are safe,
stable and long lasting.
FOCUS ON THE ENTIRE FAMILY as it is defined by the family.
PROMOTE FLEXIBLE SERVICE AND FUNDING supporting individual
and family control over who, what, when, where and how supports are
provided.
AFFIRM LIFESPAN PLANNING AND SELF-DETERMINATION that
encourages decision-making and planning for independence beginning
within the family when children are young, following the individual
throughout their life and including aging issues.
ASSURE PARTNERSHIPS WHICH ACTIVELY INCLUDE INDIVIDUALS
AND FAMILIES in planning, development, implementation and evaluation
of policies, practices and personal programs.
PRACTICE OPEN COMMUNICATION promoting a clear understanding of
all aspects of systems policy, procedure, practice and all other information
regarding them.
7
Principle Three:
Integration.
Community living includes physical, social, political, educational, and
economic integration.
GUIDELINES
The integration mandate applies to all areas of community living including
personal assistance, access to the faith community, education,
employment, health care, housing, assistive technology, recreation, and
transportation.
Services and resources are equally accessible to diverse populations.
Permanent infrastructure supports individual choices.
Funding follows the individual.
Personal relationships and community membership are valued and
supported.
Lifespan planning and self-determination encourages decision-making and
planning for independence beginning with the family and the children when
the children are young.
Segregation based on disability is unlawful discrimination.
There will be five subcommittees to accomplish the work of the large
committee. They are:
1. Dollar Follows the Individual.
2. Quality Assurance.
3. Diversion
4. Community Supports and Services.
5. Finance.
9
Goal: Explore changing the State 209(b) status and use SSI
eligibility as the financial standard. Additional funds may be needed to
expand the Medicaid population.
Agents of Change: Oklahoma Health Care Authority (OHCA),
Department of Human Services (DHS), State Legislature, Consumers,
Advocates
2. QMB-Qualified Medicare Beneficiary
Dually Eligible - Medicare/Medicaid individuals. Low income threshold is a
disincentive to enter the work force.
Goal: Study the need for a policy change that would allow for an
increase to earned income levels for dually eligible individuals.
Agents of Change:
Advocates
DHS, OHCA, State Legislature, Consumers,
3. Supplemental Security Income Work Incentive-1619(b)
SSI individuals can have an earned income that allows continued
Medicaid eligibility based on Social Security regulation 1619 (a) and (b).
Current policy language creates confusion between responsible agencies
because the OK Medicaid agency policy does not meet federal regulation
that would allow an individual to have a 1619 (b) status.
Goal: Policy change would be needed OAC 317:35-7-38(3)(E)
to eliminate the link between receiving 1619 (b) status and the state
supplement payment, based on earned income, for continued Medicaid
eligibility.
Agents of Change:
Advocates
OHCA, DHS, Social Security, Consumers,
11
3. Pre Employment Consideration
Making informed choices regarding employment, i.e. job match, benefits,
safety, and health. Poor planning that results in unsuccessful employment
outcome.
Goal: Enhance training and coordination of employment and/or
transitional services that will result in positive outcomes.
Agents of Change: DRS, SDE, DHS, Workforce, Oklahoma
Employment Security Commission (OESC), DMHSAS, OBPAP, Centers for
Independent Living (Cll), Oklahoma Association for Supported
Employment (OK-APSE)/ Consumers, Advocates
C. Assistive Technology
Medicaid Recipients Need Access to All Types of DME.
Restrictions exist on various types of DME such as, bath and toilet aids,
prosthetics, orthotics and alternative, augmentative communication (AAC).
lack of access to appropriate medically necessary equipment creates a
barrier to community living.
Goal: Amend policy to eliminate 'exclusive lists' and state plan
options for DME.
Agents of Change: OHCA, Oklahoma State Department of Health
(OSDH), ABLE Tech, DHS, Consumers, Advocates
D. Direct Support Services
1. Personal Care Services
PCS in state Medicaid plan can be provided in the home, educational or
work setting. lack of information regarding current policy on PCS creates
low utilization.
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The appropriate Oklahoma State Legislative Committee explore and
develop employee recruitment and retention incentives for all providers of
long-term care services.
Goals:
1. State agencies will address payment issues.
2. Service provider agencies will enhance hiring practices and reduce
turnover by addressing factors, such as, supervisory training, recruitment,
training and professional development, mentoring and counseling and
wages and benefits.
Agents of Change:
Consumers, Advocates
DHS, OHCA, DRS, Service Providers,
4. Identification of "Faith Based Initiatives" that may serve people
with disabilities.
To identify Faith Based resources in the community that assist people with
disabilities. Faith-Based Initiatives can be a resource for both an individual
with a disability and communities to assist with transition and inclusion.
Goal: Become familiar with the Federal and State's Faith Based
Initiatives to supplement the budgeted outreach of their congregation for
this ministry.
Agents of Change: Oklahoma's Faith Based Liaisons Office,
Developmental Disabilities Council, Consumers, Advocates
E. Transportation
1. Lack of Available Transportation
Persons with disabilities need to participate in the community. Equal
access requires ability to utilize local services and travel to other
communities. Without adequate means of transportation, persons with
disabilities have limited opportunities to participate fully in community living.
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Agents of Change:
Consumers, Advocates
ODOT, DHS, DRS, State Legislature,
4. Duplication of Transportation Services
Many funding sources restrict a vehicle's usage to only their clients.
Multi vehicles providing transportation services to same site or area.
Goal: Review regulations and, where practical, allow for the
blending of funds.
Agents of Change: Legislative transportation committees,
agencies that spend dollars to provide transportation services, Consumers,
Advocates
F. Education
There are many more aspects of education which need to be reviewed by
the committee. More work needs to be done in this area over the next year
by this or a separate committee
1. Transitioning from High School to Work
High School students may not have access to resources to gain
employment skills, i.e. job coaches. Students may not have employment
outcomes by graduation; yet, transition services end.
When IEP services end, student may lose job because they lose their
transition services.
Goals: Better coordination between various agencies to ensure
continuation. Transition services will begin at age 14 and continue through
age 21, if needed, as mandated by IDEA.
Agents of Change: State Department of Education (SDE), DRS,
Career Technology, Community Supports such as non-profits and
businesses, DMHSAS, One-Stop-Shop Centers, Consumers, Advocates
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Goal: Urge Oklahoma Public Housing Authorities (PHA)to enact
disability preferences and expedite applications for people transitioning
from institutions.
Agents of Change: HUD, PHA, Consumers, Advocates
3. Home Ownership and Supports
In Oklahoma, many citizens live in institutions who could, with the
appropriate supports, live successfully in the community.
Given their present living arrangements, these individuals have no way to
access mortgages or to take the necessary steps to become home owners.
Goal:
1. Strengthen and expand current HOVO initiatives. (~iJf), yo~•..O~)
2. Encourage state agencies to provide personnel resource assistance to
Community Action Agencies in facilitating the process of home ownership
for specific populations of persons with disabilities (i.e., DHS-DDSD for
persons with developmental delays, DMHSAS for persons with mental
illness.).
3.Establish collaborative community efforts involvinq multiple
agencies/organizations including Community Action Agency to develop
housing for disability populations. It must be acknowledged that individuals
with serious mental illness are not given access to all housing options so
that a priority for homeless mentally ill is recommended. Often the
responsibility for match or the cash outlay falls to one agency. Having the
city, county or state provide the match is an unexplored option. Providing
options for housing, by providing the match, is less costly than supporting
persons in higher levels of care.
Agents of Change: Legislature, Oklahoma Housing Finance
Administration (OHFA), Oklahoma Association of Community Action
Agencies (OACAA), Consumers, Advocates and the Developmental
Disabilities Council
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c. A method to disseminate information on trends so necessary changes
can be made;
d. A mechanism to identify gaps in services using input from individuals
and families;
e. An education and training component for individuals / families to make
informed decisions; and
f. Individuals and family involvement in the development, implementation
and evaluation of services.
Goals:
1. Develop and recommend guiding principles for QA systems across the
State of Oklahoma.
2. Identify and review relevant QA systems in Oklahoma for best
practices.
3. Review funding mechanisms for QA systems to assure adequate
staffing.
4. Assure consumers, advocates and families are included in the
development of any and all quality assurance programs.
Agents of Change: Consumers, Advocates, Family members,
Department of Human Services, Department of Health, Oklahoma Health
Care Authority
Diversion Subcommittee
Purpose: To market nd facilitate a paradi m shift from ins' utional care as
an entitlement a choice of home and mmunity bas services as the
waive red opti to home and com ity based servi es as the entitlement
and choic f institutional care a the waivered Ion. ~ ~~ ~ ~
Goal 1: Development and continuous refinement of a self-directed
service delivery system.
Objectives:: There is a single point of entry.
a. Identify the basic infrastructure for community based services available
in Oklahoma.
b. Develop the prototype for a Single Statewide Service Delivery Model
with a single point of entry.
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SUMMARY
This is the first report in a five year ongoing process. There will be a
number of focus groups throughout the State to get feedback from
consumers, family members, providers, advocates and other interested
parties. Their feedback may alter some recommendations and may
advance other options, which will be explored over the next four years.
During the next year, we will add two new committees that will look at
finances, both current and potential, and marketing of concepts and
programs. More committees will be added and removed as the Strategic
Planning Committee determines the needs.
We again want to acknowledge the hard work and commitment of the
Legislature, Olmstead Strategic Planning Committee, other committee
members, advocates, consumers, family members and providers who were
willing to share their stories to put a real face on this important issue.
The Olmstead Strategic Planning Committee would like to thank the
informal Olmstead work groups that worked for almost two years to begin
the process. They developed a foundation upon which this Committee can
build. Their report is attachment #1 in the back of this report.
We know that we must all work together to make this plan a reality and to
"Make Olmstead a reality in Oklahoma".
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